Washington, DC—Today, the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) urge Congress to take immediate action to reform the Medicare Physician Fee Schedule (MPFS) and preserve patient access to surgical care. In a statement issued by the Surgical Coalition, the groups express concern that the U.S. Centers for Medicare & Medicaid Services (CMS) continues to put forth annual regulations that exacerbate the underlying problems within the broken Medicare physician payment system. The MPFS often serves as the benchmark for determining payment rates for Medicaid and other payers, so Medicare payment cuts have a cascading effect.
Surgeons are expecting a minimum 2.8% cut due to temporary congressional relief set to expire at the end of the year. Previously, relief was provided to mitigate reductions resulting from long-term problems with the statutory budget neutrality requirement and its impact on the Medicare conversion factor. This budget neutrality rule has led to significant cuts to specialists, including neurosurgeons, over the years.
To help stabilize physician payments by improving how CMS calculates the budget neutrality adjustment, House Doc Caucus members, including co-chairs Reps. Greg Murphy, MD, (R-N.C.); Brad Wenstrup, DPM, (R-Ohio); and Michael Burgess, MD, (R-Texas) teamed up with Rep. Robin Kelly (D-Ill.) to introduce the Provider Reimbursement Stability Act (H.R. 6371), which would reform the MPFS budget neutrality requirements. Sens. John Boozman (R-Ark.); Peter Welch (D-Vt.); Thom Tillis (R-N.C.); Angus King (I-Maine); Roger Marshall, MD (R-Kan.); and Jeanne Shaheen (D-N.H.) introduced the bipartisan Physician Fee Stabilization Act (S. 4935). These two bipartisan bills would add crucial stability and predictability to Medicare physician payments.
“Without inflation-based updates, Medicare physician payments continue to lag behind rising medical costs, jeopardizing patient access to care. It’s time for Congress to address this and ensure that surgical care is valued appropriately so neurosurgeons can continue delivering high-quality care,” said Russell R. Lonser, MD, FAANS, chair of the AANS/CNS Washington Committee.
Since 2001, physicians have seen their Medicare payments decrease by nearly 30% after adjusting for inflation. Payments for evaluation and management (E/M) visits increased substantially in 2021, and the Surgical Coalition has consistently urged CMS to apply those payment increases to the post-operative visits bundled into global surgical codes. The Surgical Coalition also calls for long-term reforms to Medicare Access and CHIP Reauthorization Act (MACRA), emphasizing the need for alternative payment models while expressing concerns for the recently finalized Transforming Episode Accountability Model.
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The American Association of Neurological Surgeons (AANS), founded in 1931, and the Congress of Neurological Surgeons (CNS), founded in 1951, are the two largest scientific and educational associations for neurosurgical professionals in the world. These groups represent over 10,000 neurosurgeons worldwide. The AANS and the CNS jointly sponsor the Washington Committee for Neurological Surgery, which serves as the voice of neurosurgery before legislative bodies, regulatory agencies, and other health care stakeholders. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain and peripheral nerves. For more information, please visit www.aans.org, www.cns.org and www.neurosurgery.org.
